Application of the mixture item response theory model to the Self-Administered Food Security Survey Module for Children

Perspective: Food and Nutrition Insecurity in Europe: Challenges and Opportunities for Dietitians

In recent years, the interest in food and nutrition insecurity in high-income countries has skyrocketed. However, its recognition in Europe is still developing. This perspective summarizes the evidence on food and nutrition insecurity across Europe in terms of prevalence, consequences, and current mitigation strategies, with the aim of outlining the challenges and opportunities for dietitians. Prevalence in the general population ranges between 5% and 20%, with higher rates identified in women, children, older adults, single-parent households, those with low educational attainment, and on low or unstable income and/or employment. In users of food aid, the prevalence of food insecurity is above 70%. Responses to food and nutrition insecurity include welfare policies and food assistance programs at regional and national levels. However, most current strategies are not successful in tackling the structural drivers of food and nutrition insecurity, nor do they guarantee diet quality. Despite limited involvement to-date, dietitians can play an important role in addressing food and nutrition insecurity across Europe. This narrative identifies 4 areas: 1) create awareness of the existence and severity of food and nutrition insecurity, 2) advocate for comprehensive, robust data on the determinants and prevalence, 3) partner with diverse stakeholders, social assistance providers, local authorities, and nongovernmental organizations in a comprehensive, intersectoral, and integrated manner, 4) participate in the development of political instruments and interventions that ensure equitable access to high-quality safe food.

Associations between children's reports of food insecurity and dietary patterns: findings from the Generation XXI birth cohort

Evidence on the association between children's food insecurity (FI) and dietary patterns (DPs) is scarce. This study assessed the association between children's FI and a priori and a posteriori-defined DPs in a Portuguese population-based sample of children. A cross-sectional study including 2800 children from the 10-year-old follow-up of the Generation XXI birth cohort was performed. Data on food security status, assessed by the Self-administered Food Security Survey Module for children (SAFSSMC), dietary intake and socio-demographics were collected. A previously developed Healthy Eating Index (HEI) was adapted for this study. Using the HEI score and its food groups, linear and logistic regression models were performed. Using latent class analysis, five a posteriori-defined DPs were identified. The DPs names considered an overall picture of the DP. Food security status as a categorical (food security/FI) and continuous variable (SAFSSMC raw score: higher scores representing higher FI) was used. Multinomial logistic regression models were used to assess the association between food security status and DPs. Children's FI (9·4 %) was inversely associated with the HEI score (β=-0·695;95%CI:-1·154,-0·235), representing worse diet quality. A higher SAFSSMC raw score was associated with low fruit and vegetables (OR=1·089;95%CI:1·023,1·159) and seafood and eggs consumption (OR=1·073;95%CI:1·009,1·142) and high consumption of meat and meat products (OR=1·091;95%CI:1·026,1·160), salty snacks (OR=1·067;95%CI:1·003,1·136) and soft drinks (OR=1·097;95%CI:1·031,1·168). The SAFSSMC raw score was positively associated with 'Low consumption' (OR=1·119;95%CI:1·016,1·232), 'Energy-dense foods' (OR=1·155;95%CI:1·028,1·298) and 'Snacking' (OR=1·119;95%CI:1·006,1·245) DPs. FI was associated with worse dietary choices. Intervention strategies targeting food insecure children should be developed to promote healthy dietary habits.